| NPI | 1629033428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MO 2014036763) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: TX J9748) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: KS 04-20041) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2024-07-04 |